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Could Artificial Sweeteners Be Bad for Your Heart?

Artificial sweeteners are a popular way to try to keep slim, but French researchers suggest they may also increase your risk for a heart attack or stroke.

The finding stems from tracking heart health among more than 103,000 men and women in France for close to a decade.

“We observed that a higher intake of artificial sweeteners was associated with an increased risk of cardiovascular diseases,” said study author Mathilde Touvier. She is director of the nutritional epidemiology research team at the French National Institute for Health and Medical Research and Sorbonne Paris Nord University, both in France.

Roughly 80% of participants in the NutriNet-Santé cohort were women (average age: 42). The study began in 2009 to investigate links between nutrition and health.

At the outset, nearly four out of 10 participants reported they regularly used artificial sweeteners, including Nutrasweet (aspartame), Splenda (sucraclose) and Sunett or Sweet One (acesulfame potassium). They added them to food or beverages and also consumed them in processed products.

Those who said they used such sweeteners were generally younger; less active; more likely to be overweight or obese; more likely to smoke; and more likely to be dieting. They also tended to consume more red meat, dairy, salt, and sugar-free drinks. They drank less alcohol and ate fewer fruits and vegetables, less carbs and fats, and fewer calories overall, dietary records showed.

Participants’ heart health was then tracked and compared for an average nine years.

During that time, more than 1,500 heart problems occurred, including heart attacks, strokes, severe chest tightness or pain (angina), and/or the need for surgery to widen blocked arteries (angioplasty).

After stacking artificial sweetener consumption up against heart trouble, the researchers concluded that the former was associated with the risk for the latter.

The Calorie Control Council, which represents the artificial sweetener industry, did not respond to a request for comment.

Touvier and her team stressed that their work does not definitively prove that sweeteners directly undermine heart health, only that there’s a link between the two.

And that should give people pause before drawing firm conclusions, said Connie Diekman, a St. Louis food and nutrition consultant who is former president of the Academy of Nutrition and Dietetics.

“The challenge with most of the studies, and that is true here, is that studies have yet to provide a cause-and-effect outcome,” Diekman said. “When looking at non-nutritive sweeteners it is hard to tease out how much the overall health of the subjects is a factor in the disease outcome.”

For example, she pointed to study participants’ own description of their diet and health habits.

“The authors state that higher consumers of non-nutritive sweeteners had higher BMI’s [a measure of body fat based on height and weight], smoked more, had less physical activity, and ate more sodium and red meats, with fewer fruits and vegetables,” Diekman noted.

She also stressed the importance of accounting for the “trade-off” factor, in which someone who uses a no-calorie sweetener for an iced tea, for example, might then rationalize indulging in a bowl of ice cream. That, Diekman said, is why “the whole diet is what must be assessed.”

While the authors said they took such factors into account when determining risk, Diekman had reservations.

“Can we really determine how one single variable impacted the health of the body?” she asked. “The answer is no.”

Still, if artificial sweeteners do pose trouble for the heart, why might that be?

Lead author Charlotte Debras, a doctoral candidate at both the French National Institute for Health and Medical Research and Sorbonne Paris Nord University, suggested a number of possibilities.

One, she said, is the promotion of metabolic syndrome, which encompasses an array of conditions that raise the risk for heart attack and stroke. Among those are high blood pressure, high blood sugar, excess waist fat and high cholesterol.

“Another potential pathway could involve the interaction of artificial sweeteners with intestinal sweet taste receptors,” which can affect both insulin levels and sugar absorption, Debras said.

Artificial sweeteners may also alter the makeup of microbes found in the gut, drive up systemwide inflammation and trigger vascular malfunction, she added.

“But these are hypotheses, notably from experimental studies, that need to be confirmed,” Debras said.

Meanwhile, Diekman said the French findings do not change her dietary recommendations.

“Focus on an overall healthful eating plan,” she advised. “More plant foods, leaner or low fat animal foods, and if you enjoy something sweet, think about portions, frequency of consumption, and try to vary the types of sweeteners you use. No single food or ingredient is the ‘bad guy.’ It is how all of this comes together into your day in, and day out, eating plan.”

The report was published online in the BMJ.


Source: HealthDay

Chemicals Produced in the Gut after Eating Red Meat May Contribute to Heart Disease Risk

Chemicals produced by microbes in the digestive tract may be partly responsible for the increased heart disease risk associated with higher consumption of red meats such as beef and pork, a new study suggests.

Cardiovascular disease – which includes heart attacks and strokes – is the leading cause of death in the U.S. and around the world. As people age, their cardiovascular disease risk increases.

But risks can be lowered by eating a diet emphasizing fruits and vegetables, legumes, nuts, whole grains, lean protein and fish, staying physically active, getting enough sleep, maintaining a healthy body weight, not smoking and properly managing blood pressure, cholesterol and blood sugar levels.

“Most of the focus on red meat intake and health has been around dietary saturated fat and blood cholesterol levels,” study co-author Meng Wang said in a news release. Wang is a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

“Based on our findings, novel interventions may be helpful to target the interactions between red meat and the gut microbiome to help us find ways to reduce cardiovascular risk,” she said.

The study was published Monday in the American Heart Association journal Arteriosclerosis, Thrombosis, and Vascular Biology.

Prior research has shown some chemical byproducts of food digestion, called metabolites, are associated with a higher cardiovascular disease risk. Trimethylamine N-oxide, or TMAO, is a metabolite produced by gut bacteria to help digest red meat. High blood levels of TMAO may be associated with higher risk for cardiovascular disease, chronic kidney disease and Type 2 diabetes.

In the new study, researchers measured metabolites in the blood samples of nearly 4,000 people in the Cardiovascular Health Study, which investigated risk factors for cardiovascular disease in adults age 65 and older.

Study participants, who were an average 73 years old at the study’s onset, were recruited from Sacramento, California; Hagerstown, Maryland; Winston-Salem, North Carolina; and Pittsburgh. They were followed for an average of 12.5 years and in some cases up to 26 years.

Participants answered questionnaires about their dietary habits, including how often they ate foods such as red meat, processed meat, fish, poultry and eggs.

Eating more meat – especially red meat and processed meat – was associated with a higher risk for atherosclerotic cardiovascular disease. The risk was 22% higher for about every daily serving.

The increase in TMAO and related metabolites associated with eating red meat was responsible for one-tenth of the higher cardiovascular risk, according to the study.

Researchers also found evidence that blood sugar levels and inflammation may play a more important role in linking red meat consumption to cardiovascular risk than blood cholesterol or blood pressure.

The findings suggest a need for more research into the different chemicals that may play a role in red meat consumption, the authors said.

“Research efforts are needed to better understand the potential health effects,” Wang said.


Source: American Heart Association

American Heart Association Adds Sleep to Cardiovascular Health Checklist

Sleep duration is now considered an essential component for ideal heart and brain health. Life’s Essential 8™ cardiovascular health score replaces Life’s Simple 7™, according to a new Presidential Advisory, Life’s Essential 8—Updating and Enhancing the American Heart Association’s Construct on Cardiovascular Health, published today in Circulation, the Association’s flagship, peer-reviewed journal.

Other updates to the measures of optimal cardiovascular health, now for anyone ages 2 and older, include a new guide to assess diet; accounting for exposure to secondhand smoke and vaping; using non-HDL cholesterol instead of total cholesterol to measure blood lipids; and expanding the blood sugar measure to include hemoglobin A1c, a key measure to assess Type 2 diabetes risk.

Cardiovascular disease is the number one cause of death in the U.S. and globally. According to the Association’s 2022 Heart Disease and Stroke Statistics Update, approximately 121.5 million people in the U.S. have high blood pressure, 100 million have obesity, more than 28 million people have Type 2 diabetes, and only 1 in 4 adults reported achieving the physical activity and exercise recommended in the U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans, 2nd edition. Various research studies over the past two decades indicate more than 80% of all cardiovascular events may be prevented by healthy lifestyle and management of known cardiovascular risk factors.

“The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure or risk for Type 2 diabetes more effectively,” said American Heart Association President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, who led the advisory writing group and is chair of the department of preventive medicine, the Eileen M. Foell Professor of Heart Research and professor of preventive medicine, medicine and pediatrics at Northwestern University’s Feinberg School of Medicine in Chicago. “In addition, advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home.”

The Association first defined the 7 metrics for cardiovascular health in 2010 to identify the specific health behaviors and health factors that drive optimal heart and brain health. Brain health in relation to cardiovascular health was defined in a 2017 American Heart Association Presidential Advisory. It was further acknowledged as an important component of optimal cardiovascular health in the Association’s January 2021 Scientific Statement on the mind-heart-body connection. Findings from both papers are incorporated into Life’s Essential 8™.

After 12 years and more than 2,400 scientific papers on the topic, new discoveries in heart and brain health and in the ways to measure cardiovascular health provided an opportunity to revisit each health component in more detail. Four of the original metrics have been redefined for consistency with newer clinical guidelines or compatibility with new measurement tools. Also, the scoring system can now be applied to anyone ages 2 and older.

The Life’s Essential 8™ components of optimal cardiovascular health are divided into two major areas – health behaviors and health factors. Health behaviors include diet, physical activity, nicotine exposure and sleep. Health factors are body mass index, cholesterol levels, blood sugar and blood pressure. “The idea of optimal cardiovascular health is important because it gives people positive goals to work toward at any stage of life,” said Lloyd-Jones.

“Life’s Simple 7™ has served as a proven, powerful tool for understanding how to achieve healthy aging and ways to improve cardiovascular health while decreasing the risks of developing heart disease and stroke, as well as cancer, dementia and many other chronic diseases,” he said. “Given the evolving research, it was important to address some limitations to the original metrics, particularly in ways they’ve been applied to people from diverse racial and ethnic populations.”

Lloyd-Jones explained that some of the previous metrics, such as diet, were not as sensitive to differences among people, or as responsive to changes over time within a single individual. “We felt it was the right time to conduct a comprehensive review of the latest research to refine the existing metrics and consider any new metrics that add value to assessing cardiovascular health for all people.”

Life’s Essential 8™ includes:

1. Diet (updated): A new guide to assess diet quality for adults and children at the individual level (for individual health care and dietary counseling) and at the population level (for research and public health purposes).

  • At the population level, dietary assessment is based on daily intake of elements in the Dietary Approaches to Stop Hypertension (DASH) eating pattern. The DASH-style diet score has eight components: high intake of fruits, vegetables, nuts and legumes, whole grains, low-fat dairy, and low intake of sodium, red and processed meats, and sweetened drinks.
  • For individuals, the Mediterranean Eating Pattern for Americans (MEPA) is used to assess and monitor cardiovascular health. The MEPA is a DASH-style eating pattern that can be measured with 16 yes or no questions about the weekly frequency of eating olive oil, vegetables, berries, meat, fish, dairy, grains, etc. The MEPA screener does not include consumption of sugar-sweetened beverages, so clinicians are encouraged to ask at the time of assessment.

2. Physical activity (no changes): Activity is measured by the total number of minutes of moderate or vigorous physical activity per week, as defined by the U.S. Physical Activity Guidelines for Americans, 2nd edition. The optimal level is 150 minutes of moderate physical activity or more per week or 75 minutes per week of vigorous-intensity physical activity for adults; 420 minutes or more per week for children ages 6 and older; and age-specific modifications for younger children.

3. Nicotine exposure (updated): Use of inhaled nicotine-delivery systems, which includes e-cigarettes or vaping devices, is added since the previous metric only monitored traditional, combustible cigarettes. This reflects use by adults and youth and their implications on long-term health. Life’s Essential 8™ also includes second-hand smoke exposure for children and adults.

4. Sleep duration (new): Sleep duration is associated with cardiovascular health. Measured by average hours of sleep per night, the ideal level is 7-9 hours daily for adults. Ideal daily sleep ranges for children are 10-16 hours per 24 hours for ages 5 and younger; 9-12 hours for ages 6-12 years; and 8-10 hours for ages 13-18 years.

5. Body mass index (no changes): The writing group acknowledges that body mass index (BMI) is an imperfect metric, yet it is easily calculated and widely available; therefore, BMI continues as a reasonable gauge to assess weight categories that may lead to health problems. BMI of 18.5–24.9 is associated with the highest levels of cardiovascular health. The writing group notes that BMI ranges and the subsequent health risks associated with them may differ among people from diverse racial or ethnic backgrounds or ancestry. This aligns with the World Health Organization’s recommendations to adjust BMI ranges for people of Asian or Pacific Islander ancestry because recent evidence indicates their risk of conditions such as CVD or Type 2 diabetes is higher at a lower BMI.

6. Blood lipids (updated): The metric for blood lipids (cholesterol and triglycerides) is updated to use non-HDL cholesterol as the preferred number to monitor, rather than total cholesterol. HDL is the “good” cholesterol. Other forms of cholesterol, when high, are linked to CVD risk. This shift is made because non-HDL cholesterol can be measured without fasting beforehand (thereby increasing its availability at any time of day and implementation at more appointments) and reliably calculated among all people.

7. Blood glucose (updated): This metric is expanded to include the option of hemoglobin A1c readings or blood glucose levels for people with or without Type 1 or Type 2 diabetes or prediabetes. Hemoglobin A1c can better reflect long-term glycemic control.

8. Blood pressure (no changes): Blood pressure criteria remain unchanged from the Association’s 2017 guidelines that established levels less than 120/80 mm Hg as optimal, and hypertension defined as 130-139 mm Hg systolic pressure (the top number in a reading) or 80-89 mm Hg diastolic pressure (bottom number).

Each component of Life’s Essential 8™, which is assessed by the My Life Check tool, has an updated scoring system ranging from 0 to 100 points. The overall cardiovascular health score from 0 to 100 points is the average of the scores for each of the 8 health measures. Overall scores below 50 indicate “poor” cardiovascular health, and 50-79 is considered “moderate” cardiovascular health. Scores of 80 and above indicate “high” cardiovascular health. The advisory recommends measuring cholesterol, blood sugar, blood pressure, height and weight at least every five years for the most complete and accurate Life’s Essential 8™ score.

The writing group also reviewed data about the impacts of stress, mental health and social determinants of health, such as access to health care, income or education level, and structural racism, which are critical to understanding the foundations of health, particularly among people from diverse racial and ethnic populations.

“We considered social determinants of health carefully in our update and determined more research is needed on these components to establish their measurement and inclusion in the future,” said Lloyd-Jones. “Nonetheless, social and structural determinants, as well as psychological health and well-being, are critical, foundational factors in an individual’s or a community’s opportunity to preserve and improve cardiovascular health. We must consider and address all of these issues for people to have the opportunity for a full, healthy life as measured by Life’s Essential 8™.”

“Life’s Essential 8™ is a major step forward in our ability to identify when cardiovascular health can be preserved and when it is sub-optimal. It should energize efforts to improve cardiovascular health for all people and at every life stage,” Lloyd-Jones concluded.


Source: American Heart Association

Alcohol May be More Risky to the Heart Than Previously Thought

Levels of alcohol consumption currently considered safe by some countries are linked with development of heart failure, according to research presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC).

“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” said study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, Ireland. “To minimise the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.”

According to the World Health Organization, the European Union is the heaviest-drinking region in the world.2 While it is well recognised that long-term heavy alcohol use can cause a type of heart failure called alcoholic cardiomyopathy,3 evidence from Asian populations suggests that lower amounts may also be detrimental.4,5 “As there are genetic and environmental differences between Asian and European populations this study investigated if there was a similar relationship between alcohol and cardiac changes in Europeans at risk of heart failure or with pre-heart failure,” said Dr. Wong. “The mainstay of treatment for this group is management of risk factors such as alcohol, so knowledge about safe levels is crucial.”

This was a secondary analysis of the STOP-HF trial.6 The study included 744 adults over 40 years of age either at risk of developing heart failure due to risk factors (e.g. high blood pressure, diabetes, obesity) or with pre-heart failure (risk factors and heart abnormalities but no symptoms).7 The average age was 66.5 years and 53% were women. The study excluded former drinkers and heart failure patients with symptoms (e.g. shortness of breath, tiredness, reduced ability to exercise, swollen ankles). Heart function was measured with echocardiography at baseline and follow up.

The study used the Irish definition of one standard drink (i.e. one unit), which is 10 grams of alcohol.8 Participants were categorised according to their weekly alcohol intake: 1) none; 2) low (less than seven units; up to one 750 ml bottle of 12.5% wine or three-and-a-half 500 ml cans of 4.5% beer); 3) moderate (7-14 units; up to two bottles of 12.5% wine or seven 500 mL cans of 4.5% beer); 4) high (above 14 units; more than two bottles of 12.5% wine or seven 500 ml cans of 4.5% beer).

The researchers analysed the association between alcohol use and heart health over a median of 5.4 years. The results were reported separately for the at-risk and pre-heart failure groups. In the at-risk group, worsening heart health was defined as progression to pre-heart failure or to symptomatic heart failure. For the pre-heart failure group, worsening heart health was defined as deterioration in the squeezing or relaxation functions of the heart or progression to symptomatic heart failure. The analyses were adjusted for factors that can affect heart structure including age, gender, obesity, high blood pressure, diabetes, and vascular disease.

A total of 201 (27%) patients reported no alcohol usage, while 356 (48%) were low users and 187 (25%) had moderate or high intake. Compared to the low intake group, those with moderate or high use were younger, more likely to be male, and had a higher body mass index.

In the pre-heart failure group, compared with no alcohol use, moderate or high intake was associated with a 4.5-fold increased risk of worsening heart health. The relationship was also observed when moderate and high levels were analysed separately. In the at-risk group, there was no association between moderate or high alcohol use with progression to pre-heart failure or to symptomatic heart failure. No protective associations were found for low alcohol intake.

Dr. Wong said: “Our study suggests that drinking more than 70 g of alcohol per week is associated with worsening pre-heart failure or progression to symptomatic heart failure in Europeans. We did not observe any benefits of low alcohol usage. Our results indicate that countries should advocate lower limits of safe alcohol intake in pre-heart failure patients. In Ireland, for example, those at risk of heart failure or with pre-heart failure are advised to restrict weekly alcohol intake to 11 units for women and 17 units for men. This limit for men is more than twice the amount we found to be safe. More research is needed in Caucasian populations to align results and reduce the mixed messages that clinicians, patients and the public are currently getting.”


Source: European Society of Cardiology

Heart Risk Factors Can Be Recipe for Dementia

The faster you pile up heart disease risk factors, the greater your odds of developing dementia, a new study suggests.

Previous research has linked heart health threats such as high blood pressure, diabetes and obesity with mental decline and dementia.

Amassing those risk factors at a faster pace boosts your risk for Alzheimer’s disease and vascular dementia, according to findings published online in the journal Neurology.

“Our study suggests that having an accelerated risk of cardiovascular disease, quickly accumulating more risk factors like high blood pressure and obesity, is predictive of dementia risk and associated with the emergence of memory decline,” said study author Bryn Farnsworth von Cederwald, of Umeå University in Sweden.

“As a result, earlier interventions with people who have accelerated cardiovascular risks could be an effective way to help prevent further memory decline in the future,” he said in a journal news release.

The study included more than 1,200 people (average age: 55) who did not have heart or memory problems at the outset and were followed for up to 25 years.

By the end of the study, about 6% had developed Alzheimer’s disease and 3% developed dementia from vascular disease.

At the outset, participants’ average 10-year risk of heart disease was between 17% and 23%. As time went on, heart disease risk remained stable in 22% of participants, increased moderately in 60%, and rose rapidly in 18%.

Compared to those with a stable heart disease risk, those with an accelerated risk were three to six times more likely to develop Alzheimer’s, three to four times more likely to develop vascular dementia, and up to 1.4 times more likely to have memory decline, the study found.

“Several risk factors were elevated in people with an accelerated risk, indicating that such acceleration may come from an accumulation of damage from a combination of risk factors over time,” Farnsworth von Cederwald said.

“Therefore,” he added, “it is important to determine and address all risk factors in each person, such as reducing high blood pressure, stopping smoking and lowering BMI, rather than just address individual risk factors in an effort to prevent or slow dementia.”


Source: Healthday

New USPSTF Guidance: Continue to Take Low-dose Aspirin If You Have a History of Heart Attack, AFib, Stroke or Vascular Stenting

Earlier, the U.S. Preventive Services Task Force (USPSTF) released its final recommendations on low-dose aspirin therapy for the primary prevention of cardiovascular disease in adults: people who have a history of heart attack, atrial fibrillation (AFib), stroke or vascular stenting should continue to take low-dose aspirin, as directed by their doctor. For people who have no history of cardiovascular disease or stroke, low-dose aspirin is not recommended for prevention of heart attack or stroke, particularly for adults with higher risk for bleeding. In consultation with their physician, select middle-aged adults may benefit from low-dose aspirin therapy if they are at high risk for heart attack or stroke due to risk factors such as smoking, hypertension, Type 2 diabetes, high cholesterol or significant family history. The USPTSF is an independent, volunteer panel of medical experts focused on improving the health of people nationwide by making evidence-based recommendations on effective ways to prevent disease and prolong life.

The following statement reflects the views of the American Heart Association/American Stroke Association.

According to the Association’s volunteer President Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, “If you are already taking low-dose aspirin because you have had a heart attack, stroke or stenting or you have a history of AFib, continue to take it as directed by your physician; this new guidance about low-dose aspirin does not apply to your situation. Do not stop taking aspirin without first talking with your doctor.

“The new guidance revising the recommendations on the use of low-dose aspirin strictly applies to adults who have not had a cardiovascular event or any heart disease diagnosis: low-dose aspirin is not appropriate to prevent a first heart attack or stroke in most people. Due to the blood-thinning effects of aspirin, research continues to indicate that for most adults the risk of bleeding may be greater than the number of heart attacks or strokes actually prevented.

“We continue to urge clinicians to be extremely selective when prescribing aspirin for adults without known cardiovascular disease. For example, people with higher risk for gastric or intracerebral bleeding should not take aspirin to prevent a CV event. Aspirin should be limited to only those adults at the highest risk for cardiovascular disease due to the presence and severity of other risk factors, such as smoking, hypertension, Type 2 diabetes, high cholesterol or significant family history, who also have a very low risk of bleeding. Some recent evidence also indicates some people with higher coronary calcium scores, >100 units, indicating higher plaque burden and risk, may also benefit from aspirin therapy if they have no history of prior bleeding.”

Lloyd-Jones, also the chair of the department of preventive medicine and the Eileen M. Foell Professor of Heart Research and professor of preventive medicine, medicine and pediatrics at Northwestern University’s Feinberg School of Medicine in Chicago, stressed the importance of healthy choices for primary prevention of cardiovascular disease, “Various research studies over the past two decades indicate more than 80% of all cardiovascular events may be prevented by healthy lifestyle changes and management of known risk factors (like high blood pressure and adverse cholesterol levels) with medication when needed. Eating healthy foods and beverages, regular physical activity and not smoking are key. The scientific evidence continues to confirm healthy lifestyle habits and effectively managing blood pressure and cholesterol are the top ways to prevent a first heart attack or stroke, not low-dose aspirin. The new USPSTF guidance now aligns with American Heart Association’s 2019 primary prevention guideline. Consult with your doctor and health care team before making any changes in your medications.”


Source: American Heart Association

Eating an Avocado Once a Week May Lower Heart Disease Risk

Eating two or more servings of avocado weekly was associated with a lower risk of cardiovascular disease, and substituting avocado for certain fat-containing foods like butter, cheese or processed meats was associated with a lower risk of cardiovascular disease events, according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Avocados contain dietary fiber, unsaturated fats especially monounsaturated fat (healthy fats) and other favorable components that have been associated with good cardiovascular health. Clinical trials have previously found avocados have a positive impact on cardiovascular risk factors including high cholesterol.

Researchers believe this is the first, large, prospective study to support the positive association between higher avocado consumption and lower cardiovascular events, such as coronary heart disease and stroke.

“Our study provides further evidence that the intake of plant-sourced unsaturated fats can improve diet quality and is an important component in cardiovascular disease prevention,” said Lorena S. Pacheco, Ph.D., M.P.H., R.D.N., lead author of the study and a postdoctoral research fellow in the nutrition department at the Harvard T.H. Chan School of Public Health in Boston. “These are particularly notable findings since the consumption of avocados has risen steeply in the U.S. in the last 20 years, according to data from the U.S. Department of Agriculture.”

For 30 years, researchers followed more than 68,780 women (ages 30 to 55 years) from the Nurses’ Health Study and more than 41,700 men (ages 40 to 75 years) from the Health Professionals Follow-up Study. All study participants were free of cancer, coronary heart disease and stroke at the start of the study and living in the United States. Researchers documented 9,185 coronary heart disease events and 5,290 strokes during more than 30 years of follow-up. Researchers assessed participants’ diet using food frequency questionnaires given at the beginning of the study and then every four years. They calculated avocado intake from a questionnaire item that asked about the amount consumed and frequency. One serving equaled half of an avocado or a half cup of avocado.

The analysis found:

  • After considering a wide range of cardiovascular risk factors and overall diet, study participants who ate at least two servings of avocado each week had a 16% lower risk of cardiovascular disease and a 21% lower risk of coronary heart disease, compared to those who never or rarely ate avocados.
  • Based on statistical modeling, replacing half a serving daily of margarine, butter, egg, yogurt, cheese or processed meats such as bacon with the same amount of avocado was associated with a 16% to 22% lower risk of cardiovascular disease events.
  • Substituting half a serving a day of avocado for the equivalent amount of olive oil, nuts and other plant oils showed no additional benefit.
  • No significant associations were noted in relation to stroke risk and how much avocado was eaten.

The study’s results provide additional guidance for health care professionals to share. Offering the suggestion to “replace certain spreads and saturated fat-containing foods, such as cheese and processed meats, with avocado is something physicians and other health care practitioners such as registered dietitians can do when they meet with patients, especially since avocado is a well-accepted food,” Pacheco said.

The study aligns with the American Heart Association’s guidance to follow the Mediterranean diet – a dietary pattern focused on fruits, vegetables, grains, beans, fish and other healthy foods and plant-based fats such as olive, canola, sesame and other non-tropical oils.

“These findings are significant because a healthy dietary pattern is the cornerstone for cardiovascular health, however, it can be difficult for many Americans to achieve and adhere to healthy eating patterns,” said Cheryl Anderson, Ph.D., M.P.H., FAHA, chair of the American Heart Association’s Council on Epidemiology and Prevention.

“We desperately need strategies to improve intake of AHA-recommended healthy diets — such as the Mediterranean diet — that are rich in vegetables and fruits,” said Anderson, who is professor and dean of the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego. “Although no one food is the solution to routinely eating a healthy diet, this study is evidence that avocados have possible health benefits. This is promising because it is a food item that is popular, accessible, desirable and easy to include in meals eaten by many Americans at home and in restaurants.”

The study is observational, so a direct cause and effect cannot be proved. Two other limitations of the research involve data collection and the composition of the study population. The study analyses may be affected by measurement errors because dietary consumption was self-reported. Participants were mostly white nurses and health care professionals, so these results may not apply to other groups.


Source: American Heart Association

Will a Little Drinking Help Your Heart? Maybe Not

If you believe an occasional tipple is good for your heart, a new study may make you reconsider the notion.

Some previous research has suggested that light drinking may benefit the heart, but this large study concluded that any amount of drinking is associated with a higher risk of heart disease, and that any supposed benefits of alcohol may actually be due to healthy lifestyle habits practiced among light and moderate drinkers.

“The findings affirm that alcohol intake should not be recommended to improve cardiovascular health; rather, that reducing alcohol intake will likely reduce cardiovascular risk in all individuals, albeit to different extents based on one’s current level of consumption,” study senior author Dr. Krishna Aragam said in a Massachusetts General Hospital news release. He’s a cardiologist at the hospital and an associate scientist at MIT’s Broad Institute.

In the study, the researchers analyzed data from more than 371,000 British adults who had an average of nine drinks a week.

As in previous studies, this new paper found that light to moderate drinkers had the lowest heart disease risk, followed by people who did not drink. People who drank heavily had the highest risk.

However, light to moderate drinkers tended to have healthier lifestyles than those who didn’t drink, including more physical activity, more vegetables in their diet and less smoking.

Taking just a few healthy lifestyle factors into account made any benefit associated with alcohol less significant, according to the study published in the journal JAMA Network Open.

The researchers also conducted a genetic analysis of samples from study participants and discovered substantial differences in heart risk from drinking, with minimal increases in risk when going from zero to seven drinks per week, much higher increases when going from seven to 14 drinks per week, and especially high risk with 21 or more drinks per week.

Significantly, the findings suggested a rise in heart risk even at levels of drinking considered “low risk” by the U.S. Department of Agriculture (less than two drinks per day for men and one drink per day for women), the study authors noted.

The finding that the connection between heart risk and drinking is an exponential one rather than a linear one was supported by an additional analysis of data from more than 30,000 U.S. participants in the Mass General Brigham Biobank.

That means that reducing drinking can benefit even people who have just one alcoholic beverage per day, but the health benefits of cutting back may be more substantial in those who drink more, according to the researchers.


Source: HealthDay

Eating Too Many Sulfur Amino Acids May Boost Cardiovascular Disease and Death Risk

Eating too much food containing sulfur amino acids – primarily found in proteins such as beef, chicken and dairy – may increase a person’s risk of cardiovascular disease and death, according to new preliminary research.

Sulfur amino acids are essential for metabolism and overall health, but the average person in the United States consumes far more than needed – as much as two and a half times the estimated average requirement.

“This may provide part of the reason why people who consume diets that emphasize healthy plant foods have lower rates of cardiovascular disease than those who eat large amounts of meat and dairy foods,” said Laila Al-Shaar, an assistant professor of epidemiology at Penn State University College of Medicine in Hershey, Pennsylvania. She led the study presented Thursday at the American Heart Association’s Epidemiology and Prevention, Lifestyle and Cardiometabolic Health conference in Chicago.

The researchers analyzed data from 120,699 people in two long-term national studies, the Nurses’ Health Study and Health Professionals Follow-up Study. Participants completed detailed health questionnaires, including questions about their diets, every two to four years.

On average, participants ate more than twice the recommended daily amount of sulfur amino acids, mostly from beef, chicken and milk. After adjusting for other cardiac risk factors, the researchers found that, compared to those who ate the least, those who consumed the most sulfur amino acids had a 12% increased annual risk of developing cardiovascular disease and a 28% increased risk of dying from the condition over the 32-year study period. The results are considered preliminary until the full findings are published in a peer-reviewed journal.

The vast majority – at least 94% – of the participants were non-Hispanic white men and women, and because they were health professionals, their socioeconomic status may not represent the overall population. This means the results might not be generalizable to other groups, Al-Shaar said. So, other studies should include populations with different dietary behaviors, specifically those whose protein intake is primarily from plant sources, she said.

Several animal studies in the past few decades have shown that restricting these types of amino acids – notably methionine and cysteine – delayed the aging process and helped animals live longer, but translating those benefits to people has proven to be difficult.

A study from the same Penn State research group published in The Lancet’s eClinicalMedicine journal in 2020 linked higher consumption of sulfur amino acids to higher cardiometabolic disease risk. But it was based on estimated diets from participants filling out just one or two questionnaires about their diets during the previous 24 hours. This new research builds on that work, with the advantage of using long-term diet data assessed by repeated food frequency questionnaires and health outcome data.

It also builds on a study Al-Shaar led as a postdoctoral research fellow in the Harvard T.H. Chan School of Public Health in Boston. Published in the BMJ in 2020, it suggested that substituting high-quality plant foods such as legumes, nuts or soy for red meat might reduce coronary heart disease risk in men.

Al-Shaar said people can get their estimated average requirement of sulfur amino acids – 15 milligrams per kilogram of body weight per day – through plant-based sources or fish. For a 150-pound adult, for instance, that would mean 1 cup of tofu and 1 cup of lentils a day. It can be also met through consuming a 3-ounce fillet of tuna.

“Since red meat has been found to be associated with worse health outcomes,” she said, “it would be better to focus on healthier sources of proteins for meeting the average requirement of sulfur amino acids.”

The new research adds focus to the overall way adults eat in the U.S. and highlights that a healthy diet should incorporate more fruits and vegetables, said Judith Wylie-Rosett, a professor of epidemiology and population health at Albert Einstein College of Medicine in New York.

“We all need to look at dietary patterns because the American dietary pattern is far from the recommendations,” said Wylie-Rosett, who was not involved in the study. “But this study doesn’t give evidence that we should be focusing only on those two amino acids.”

The study also fits in with current research about metabolism and specific biomarkers, known as “metabolomics,” a tool that supports precision medicine tailored to a specific patient.

“We’re moving toward precision nutrition,” Wylie-Rosett said. “We’re getting much more sophisticated in how we can look at nutrition. This was a fairly simple study but may help inform future studies about some of these more complex ways of looking at nutrition and metabolism.”


Source: HealthDay

Never Too Late: Starting Exercise in 70s Can Help the Heart

Steven Reinberg wrote . . . . . . . . .

Here are some numbers that could add up strongly in your favor.

If you’re in your 70s and get 20 minutes a day of moderate to vigorous exercise, you may ward off heart disease in your 80s, new Italian research suggests.

In the study of close to 3,000 Italians over 65, regular exercise was linked with a 52% lower risk of heart disease among men. Women also benefited.

The greatest benefit seemed to occur at age 70. Risk was only slightly lower at 75 and no lower in the early 80s, the study found.

“Engaging in physical exercises daily is of great importance even in late life, but at the same time, the sooner one starts, the better,” said lead researcher Dr. Claudio Barbiellini Amidei, of the University of Padua in Padova, Italy.

“These results reinforce the importance of promoting physical activity at all ages,” he added.

Researchers stressed that this study doesn’t prove that exercise alone prevents heart disease, only that there appears to be a connection.

Dr. Gianfranco Sinagra of the University of Trieste in Italy, who wrote an editorial that accompanied the findings, agreed.

“Even a small amount of physical activity confers beneficial effects in older people, however this benefit is mostly evident when an active lifestyle is present early in late life,” he said.

He said the beneficial effect of physical activity may be due to its ability to slow down atherosclerosis. Atherosclerosis is a disease in which cholesterol plaque builds up in arteries, obstructing blood flow.

“Movement is medicine also in late life,” Sinagra said, calling on health care providers to urge younger patients who are inactive to get moving and maintain adequate activity to obtain significant benefits to heart health and life expectancy.

“The routine assessment and promotion of physical activity should become a standard in health care,” he said.

For the study, Amidei’s team collected data on close to 3,100 Italian seniors who took part in a mid-1990s study. It began in 1995 and 1997, and follow-up was done four and seven years later. Participants answered questions about their physical activity levels at each assessment.

Moderate physical activity included walking, bowling and fishing. Vigorous physical activity included gardening, gym work outs, cycling, dancing and swimming. Those who exercised 20 or more minutes a day were defined as active and those who did less were considered inactive.

The researchers also gathered information on income, education, smoking and drinking. They tracked the health of all participants via hospital records and death certificates through the end of 2018.

In all, complete data were available for more than 2,700 participants, of whom 60% were women. Throughout the study, more than 1,000 participants were diagnosed with heart disease, heart failure or stroke.

Increasing levels of exercise and maintaining an active lifestyle were tied with lower risks of heart disease and death in both men and women, researchers found.

The biggest reduction was seen for coronary heart disease and heart failure in late old age. No significant link between physical activity and stroke was seen.

Dr. Gregg Fonarow, director of the Ahmanson-University of California, Los Angeles, Cardiomyopathy Center, reviewed the findings.

“Regular physical activity has been associated with improved cardiovascular health, including lower risk of [heart attack], heart failure, stroke and premature cardiovascular death,” he said. “Studies have shown these associated benefits are seen across the lifespan in both men and women.”

There are many ways physical activity can reduce the risk of heart disease and improve function, he said.

“These findings suggest that at every age, it is not too late to derive health benefits from physical activity,” Fonarow said.

The American Heart Association recommends:

  • At least 150 minutes a week of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity — or a combination of both, preferably spread throughout the week.
  • Moderate- to high-intensity muscle-strengthening activity, such as resistance or weights, at least two days per week.
  • Sitting less. Light-intensity activity can offset some of the risks of being sedentary.
  • Being active at least 300 minutes a week, for greater benefits.
  • Increasing the amount and intensity of exercise gradually over time.

The findings were published online in the journal Heart.


Source: HealthDay